What Hurts The Most
by AddisonAddekt89
Summary: Addison's life after her breakup with Derek, and a possible friendshipt with Izzie. This is before Denny's death, see if a tragedy can possibly finally bring Addison the friend she needed.
1. Chapter 1

_"Dr. Bailey, we need you in OR 3. Dr. Bailey, OR 3."_

Addison Shepherd's first instinct was to jump as though her name had been called over the PA system, nearly causing coffee to splash over the thigh of her white lab coat.

Yeah.

That would have been good. Addison shook her head, taking one last sip from the Styrofoam cup before tossing it in the trash, heading out of the lounge and into the tunnels. Passing the elevator, as though time were the most ironic thing in the world, the doors open and Derek Shepherd walked out. Addison's heart jumped in her throat, but both cast an uneasy glance at one another.

"Dr. Shepherd."

"Dr. _Montgomery_ Shepherd."

Addison nodded a greeting to her ex-husband, but couldn't stop the dull ache in her heart. So many memories so dearly missed. Why did things have to be so awkward?

Stupid question.

Addison frowned as Derek's face popped into her mind, his bright blue eyes soft and that smile of genuine affection crossing those soft lips.

Unfortunately, the look wasn't directed at her. Ever.

No. It was for Meredith Grey. Daughter of the legendary Ellis Grey.

Addison ripped a patient's file out of the holder outside one of the rooms. Her fingers closed around the metal doorknob, but she paused, taking in a deep breath, straightening her shoulders and exhaled slowly.

_Don't let him get to you like this, Addie. _She throttled herself on the inside for even a negative emotion show within radius of her patients. She composed herself and entered, brushing a strand of dark red hair behind her ear as she came into the presence of a young pregnant woman and an older one who Addison assumed to be her mother.

"Michelle. Mrs. Lawson." Addison nodded to both women with a smile. "I'm Dr. Montgomery Shepherd. I'll be helping you through the pregnancy, Michelle.

"What about a C-section?" Mrs. Lawson asked anxiously. Addison caught the exasperated flash in Michelle Lawson's green eyes. "I hear they're so much safer nowadays than a natural birth."

"Mom, I'm not having a C-section." Michelle said firmly, almost irritably. Addison flicked on the sonogram, then pulled on a pair of latex gloves and smeared KY Jelly on the hand piece, pushing Michelle's gown up her swollen belly and began the procedure, satisfied when she heard the repeated whoosh of the baby's heartbeat. "You had me without a C-section. I want to be involved in the birth."

"Sweetheart, the C-section wasn't really around when you were born." Mrs. Lawson told her. Both women paused as they listened to the fetal heartbeat, and a glowing smile spread across Michelle's face.

"See? The baby's healthy." She said. "I want to be awake to hear that."

"It's not the baby I'm concerned about, Michelle. It's you." Mrs. Lawson protested. Addison printed out the image of the almost full-grown fetus then turned to Michelle's bedside.

"How old are you, Michelle?"

"She'll be eighteen in April." Mrs. Lawson cut in before Michelle could answer. Addison's eyebrows shot up and Michelle threw her mother a scathing glance.

"Well, in that case I really would suggest the cesarean." Addison admitted. "Your body's not really strong enough to handle the birth, Michelle. I think the C-section would be the safest way."

"No. I'm having the baby myself." Michelle insisted. Mrs. Lawson shot Addison a pleading look.

"Erm…can I speak with you outside?" Mrs. Lawson asked. Addison paused, shutting Michelle's file and held it propped against her chest. "Of course. Michelle, I'll have someone in here to tend to you further in a few moments."

They walked out of the room and Addison shut the door behind them.

"Dr. Shep—"

"—_Montgomery_. Please." Addison corrected her as politely as she could.

"Dr. _Montgomery_." Mrs. Lawson chewed her lip. "I don't want Michelle having a natural birth. Can you please speak with her? I know it's too risky, and you do too."

Addison sighed. "Mrs. Lawson, there really is nothing I can do other than try to explain to Michelle the risks. I can't operate without the patient's consent."

Mrs. Lawson nodded slowly, her gaze lowering and she walked back into the room. Addison exhaled, reaching to rub the back of her neck in uneasiness. What could she possibly do? If the girl didn't want to have the Cesarean, there was no way Addison would be able to get her to do so, and they'd have one hell of a time finding a surgeon who would. Turning on her heel, Addison headed back down the hallway, drawing to a halt at the nurse's station.

"Dr. Montgomery-Shepherd?"

Addison's head shot up and she found herself looking into the bright brown eyes of Izzie Stevens, one of Seattle Grace's five interns. As a matter of fact, Addison found herself relieved that it wasn't Meredith.

"Dr. Stevens," Addison handed Nurse Debbie the patient's file and turned to look at the blonde intern. "What can I do for you?"

"Well, I was wondering if you needed an intern." Izzie shifted uneasily, and must of seen Addison's surprised expression. "Listen, I remembered what you said. That I could be like you, and that you could teach me. I want to work with you, I really do. I respect you and really think you could teach me quite a bit."

Addison searched Izzie's eyes and a grin crossed her face as she handed Izzie the file. "Welcome aboard Dr. Stevens. Glad to see you change your mind."


	2. Chapter 2

_**Updated 11/6/06**_

_**Author's Note:**_

_Sorry for the wait, guys. Here's the second chapter. _

An hour later, Addison headed into the consultation room, with Izzie at her side. Michelle's sonogram was in her hand, and it didn't look good.

"Take a look at this, Dr. Stevens." Addison handed Izzie the sonogram. "Tell me what you think."

Izzie's brown eyes trailed about the page, and her expression sobered. "Is that the fetus?"

"Yes. Big, isn't it?" Addison slid into one of the chairs, leaning back before trailing a hand through her red hair. "Too big."

"She wants to have the baby naturally, right?" Izzie looked at Addison, who was leaning against the wall, hand on her hips, over her shoulder. Addison nodded, shifting her weight uneasily from one leg to the other, but she didn't want Dr. Stevens to see her anxiety. Call it the surgeon's ego, if you will. But Addison probably had it more than anyone.

"She does, but at this point, I can't see it happening." Addison responded, her voice somewhat tight, blue eyes fixated on the sonogram. "Dr. Stevens, can you inform the Lawsons of the situation? Tell Michelle that I can't let her have the baby naturally"

Izzie nodded in understanding and made a beeline for the door. Addison blew out a breath, looking over the mental image her mind had taken of the sonogram. That worried her. The girl was too young to be having a baby that big naturally.

Thank God she wasn't going into labor yet.

Shoulders dropping in a meager attempt to relax, Addison headed out and into the staff lounge, pouring coffee into a Styrofoam cup and capping it with a lid.

"Addison." Addison jumped and whirled around at the voice, finding herself staring into Derek Shepherd's eyes.

"Dr. Shepherd," She greeted almost robotically, no feeling in her tone whatsoever. Derek couldn't stand it. He didn't love her as he did before, but he still cared about her, and couldn't stand having her obviously so broken up about the situation and not even showing it.

"Addi, cut the formalities. Eleven years and all I get is 'Dr. Shepherd?'" Derek's tone was light, but Addison could see the worry in his eyes. Both hands reached for her elbow gently, a gesture showing his attempt at reaching out to her, but she shrugged away. "Are you OK?"

"Of course, Derek, why wouldn't I be?" Addison's voice held a higher pitch, almost hysterical, than she had planned. She whirled around with her back to him when she felt the lump rise in her throat, and she set the coffee cup down and pressed a closed fist to her lips, fighting to keep it together.

_God damnit, Derek. You're the only person who could bring this out of me—_

"I can name a number of reasons why," Derek said softly. Addison gave a bitter laugh, whirling back around. To Derek's alarm, his ex-wife had tears in her eyes.

"No, really Derek?" Addison tried to spat with as much malice as she could, her only means of protecting herself, but somehow couldn't manage it at this point. "You leave New York because you were angry at me. I drag my entire _life _over here to try to make you give me a chance to show you how badly I felt about the incident—I worked my _ass _off to try to make you forgive me."

"I can never truly forgive you for what happened, Addi, you know that." Derek murmured, his tone gentle, but it couldn't stop the sting from the reality of his words.

"I _know_, Derek." Addison retorted, wiping the remaining tears from her eyes with her thumb. "For Christ sake, I _know_. You haven't got the slightest idea how much that hurts, and because I know that I deserve it."

They stood quietly for another moment or so, but to both of them it felt like hours. Painfully long moments of that awkward silence, knowing that they both had been at fault one way or another. A door opening brought both of them back to reality.

"Dr. Shepherd?" Nurse Debbie's head appeared in the doorway.

"Yes?" Both Shepherds responded in unison, then shot each other uneasy looks. Nurse Debbie blinked.

"Er…Dr. _Montgomery_-Shepherd." Debbie corrected herself. "There's a problem in the Lawson's room…you'd better come quick."

_Oh, God. _Addison chastised herself as she bolted out the door without a second glance at Derek. _Izzie._


	3. Chapter 3

**_Updated 11/7/06_**

_**Author's Note:**_

_Thanks for the comments, guys. I've finally figured out how to update the story by chapter… and as long as my grades stay up I'll be able to update sooner. Here's the third chapter._

"_No! I'm having the baby!" _ Addison heard the panicked yell from inside the Lawson's hospital room, and it didn't take her long at all to realize who it was. Her step quickened and when she reached the door, she saw Michelle practically leaning over the bed toward Izzie, screaming at her in a fit of upset, panic… and now that Addison looked closer…_pain_.

Izzie was standing more toward the corner, shying slightly away from the bed and it's maniacal resident. Although trying to be assertive while keeping her bedside manner at the same time, Izzie just looked completely wigged out by the hysterical patient.

"I'm sorry, Ms. Lawson. I really am, but the baby's big…too big for you to have it naturally—" Izzie began but with a sobbing intake of breath, Michelle abruptly cute her off.

"_NO!_ I'm having it, _damnit!_" She sounded almost fearful with each ragged breath. "I don't want to be cut open to get the baby out—I can't. Allie—_Arrgh!_"

With a painful cry, Michelle lurched forward and almost fell out of the bed. Addison rushed to Izzie's rescue…and Michelle's. She caught the sobbing girl by her shoulders, giving her something to lean against. As she did, Michelle dropped forward into Addison, crying hoarsely into the doctor's shoulder. Addison held her for a few moments until Michelle pulled away, and helped her back into the bed.

"Michelle, you have to listen to me." Addison's blue eyes locked on the girl's teary brown ones. "You cannot have the baby naturally. As your doctor, my job is to save you and the baby. By having this baby naturally, both of you could die, do you understand me?"

"What? Oh, my God!" Mrs. Lawson cried out, covering her mouth with her hands. Addison hadn't even known she was in the room at the time. Her focus was locked on Michelle.

"It's too soon—it's too soon—" Michelle sobbed in pain, and it's at that point that Addison caught a glimpse of red on the sheets and Michelle's gown. She pulled the sheets back and saw a large circle of blood staining the sheets under Michelle, and Addison's heart jumped in her throat.

"Oh, _shit._" Addison spat under her breath, her heart racing in her chest. Her head whipped over her shoulder to Izzie. "Dr. Stevens, page the Nurse's station. Tell them it's a 911. Now!"

Addison spent nearly three hours in the OR just minutes after that. Michelle had gone into shock, and Addison had to put her under the knife sooner than she'd hoped. With Isobel Stevens at her side throughout the whole surgery, Addison painstakingly tried to save both baby and mother. The strain from Michelle's hysterics had caused and artery in her uterus to burst, which explained the shocking amount of blood. After that, the girl went into shock.

"Dr. Shepherd, her blood pressure's dropping." A nurse told her from the heart monitor. Addison was in a zone. Her only focus at this point was getting both mother and baby out of there alive. She'd known Michelle forever, it seemed like, and had grown exceptionally close with the girl. No way in hell was she just going to let this sweet, bright young girl just slip away.

"No." Addison muttered, exploring the uterus and trying to find the ruptured artery. Blood pumped furiously, making it almost impossible for Addison to see. When the scrub nurse mopped it away, the cavity would fill again.

"She's losing blood fast," Addison cursed under her breath, reaching for another gauze pad as the scrub nurse sucked the blood away with another tool, only to watch it fill again.

"She's bleeding out, Dr. Montgomery-Shepherd." The scrub nurse told her. Addison shook her head.

"No, stay with me, Michelle. C'mon, honey." Addison pleaded under her breath as she finally reached the artery. She reached for the needle to try to close it, but soon the monitor began beeping and she looked up to see the girl's heart rate go flat.

"She's flatlining."

"No! Damnit, stay with me." Addison whipped her head around, tried to jumpstart the heart again with the help of another nurse.

After a few moments, there was no change. Addison just started blankly at the monitor, unable to believe it.

"We can still get the baby out alive." She said, turning to Izzie. "Dr. Stevens, what's the fetal heartrate?"

"She's stable, Dr. Shepherd. But might not be for long" Izzie responded. Addison moved quickly and made another incision in the uterus. Finally reaching the fetus, Addison pulled it out slowly with Izzie's and another scrub nurse's help and brought it over to the table after cutting the umbilical chord. Addison cleared the mucus from the baby's mouth and nose and tried to get it breathing with an aspirator. After a couple of pumps, the little girl's chest rose and fell, and followed by a piercing wail.

"She's beautiful," Izzie breathed. But Addison, as relieved as she was, couldn't be as happy. She didn't even look at the nurse when she asked.

"Time of death?"

"17:48 p.m." The nurse responded. Addison shook her head.

"Izzie, can you get the baby in an incubator?" She said softly. "I'm going to find Michelle's mother."

Throat tight, and her stomach in a knot, Addison headed down the hallway to the waiting room. Izzie watched from the nursery, standing by the little girl. She was beautiful, with big brown eyes and a head full of dark brown hair. Izzie saw Addison approach Mrs. Lawson, and the other woman stand up. Addison seemed as though she were saying something to her, and Mrs. Lawson dropped into a chair in shock. As Addison knelt down by her, Mrs. Lawson burst into tears.

About an hour later, after Mrs. Lawson filled out all the papers needed, Addison couldn't take it anymore. She sat behind a wall near the stairway, leaning against the wall with her knees pulled up to her chest. Her head rolled to the side against another wall as tears streamed down her face. There it was. She'd done what she wanted. She saved a beautiful, healthy little girl… but now that girl was going to grow up without a mother. The very thought broke Addison's heart.

"Dr. Shepherd?" Addison didn't respond when she heard Izzie's voice. She knew the intern was going to find her, and for once in her life, she didn't care. Izzie's blonde head appeared and she looked at the attending surgeon, approaching slowly.

"Addison? Are you Ok?"

Addison didn't make a sound, but tears streamed down her face. "I tried. I really did," She murmured, swallowing. "I wanted more than anything to save Michelle. If only I had gotten her into surgery sooner." Her shoulders gyrated as a strangled sob broke from her. "If I had, maybe that little girl in the nursery would have a mother."

Izzie swallowed as Addison's head dropped into her arms and the older woman broke down into tears. Her shoulders rocked with each painful sob, and Izzie couldn't bear it any longer. The woman sitting there hurting so badly was no longer her teacher and mentor, but a friend. Izzie slid down against the wall beside Addison and wrapped an arm around the other woman's shoulders.

"It wasn't your fault, it really wasn't." Izzie murmered softly, her hand gently rubbing the small of Addison's back as she lay her forehead against the other woman's shoulder. To her amazement, and almost relief, Addison seemed to accept it, and cried while leaning into Izzie's embrace. In fact, she didn't care at all. For once, it was a huge relief to be able to turn to somebody for once, to feel safe and have a sturdy wall to fall against. For the first time in Addison's life, she allowed the tables to turn, and found herself feeling grateful that Izzie was there.


End file.
